Sciatica or radicular pain is one of the main causes of consultation in hospital emergency rooms.
This pain can be acute or become chronic and can be very annoying. It consists of an electric shock type pain, numbness or radiating pain that is reflected in different parts of the leg and can reach the foot or even both feet.
Although it usually subsides within a few days and the pain is controlled, when the pain is very intense, persists and cannot be relieved with conventional analgesics, it is advisable to see a pain treatment specialist.
Dr. Jorge Orduña, head of the Pain Unit at Quirónsalud Torrevieja, explains more about sciatica and its most advanced treatments.
What is sciatica: why it occurs and its symptoms?
Sciatica is the “popular” name for radicular pain, which is the pain that occurs, in the form of an electric shock and numbness, when the spinal nerves are compressed.
The spinal nerves are responsible for providing sensation and mobility to the legs, and can be compressed at various points along their path from the spinal cord to the foot.
As Dr. Jorge Orduña explains, this compression “produces an initial inflammation which, over time and depending on the intensity of its cause, can cause lesions in the nerve, leaving sequelae”.
The symptoms of sciatica are:
● Pain running down different parts of the leg / arm / chest or abdomen.
Sensation of numbness in a particular area of the leg / arm / chest or abdomen.
Sensations of electricity, hypersensitivity or burning in specific areas of the leg / arm / chest or abdomen.
● Motor weakness of the painful area.
In addition, depending on the degree of compression, nerve injury and whether there is one or several compressions, the symptoms will be more or less acute and will affect “only one side of the body, both sides or different parts”.
Types of sciatica
● Protrusion / herniation. This is a disruption of one of the discs in the spinal column and its protrusion out of its usual area.
● Intervertebral foramen. This is a narrowing of the bony canal through which the nerves exit: osteoarthritis of joints called facets causes it to narrow and makes it difficult for the nerve to exit, causing compression.
Stenosis of the canal through which the nerves pass. Usually caused by calcification of ligaments/arthrosis of the joints or disc disorders that compress the spinal nerves in their pathway.
How can sciatica be treated?
The treatment of sciatica depends on three factors:
● The intensity of the pain.
Whether there is associated weakness.
The period of evolution.
Once the level of nerve compression has been localised and defined, specialists can opt for pharmacological or interventional (infiltration) treatments to treat the problem from where it is occurring.
“These interventional treatments (infiltrations) allow for immediate pain relief with little or no recovery time. The prolonged duration of relief allows us to work together with rehabilitators/physiotherapists and functional recuperators in activities aimed at strengthening the structures adjacent to the injured area and thus protecting it, in many cases allowing quality of life to be restored. The specialist explains.
Treatment
Some of the techniques used in the Quirónsalud Torrevieja Pain Unit to treat sciatica are:
● Lumbar epidural. Thanks to the use of X-rays, specialists deposit medication next to the compression of the spinal nerves, improving the pain from where it is being produced.
Radiofrequency of the dorsal root ganglion of the spinal nerve. In this neuromodulatory treatment, the physician places a needle with which he transmits electricity to modulate pain transmission in the area of the central nervous system where pain information is integrated.
Posterior cord neurostimulation. This is an advanced treatment in which an electrode is placed on the patient’s spine.
Intradiscal treatments with regenerative medicine. The aim is to deposit pro-regenerating substances from the patient’s own body in different parts of the damaged disc, improving situations of disc arthrosis, protrusions and herniated discs.
Intradiscal treatments with radiofrequency/laser or substances. These are applied directly to the inside of the damaged disc.
What is the success rate of these techniques?
According to Dr. Jorge Orduña, all these techniques “achieve, in a high percentage of cases, relief of more than 80% of the pain with periods of pain relief of more than 6 months”.
Furthermore, some of these treatments, such as intradiscal treatments, “can be practically definitive, while neurostimulation is applied to patients who have already undergone surgery, providing relief for many years”.
The Pain Unit at Quirónsalud Torrevieja includes specialists in pain treatment (anaesthesiologists, rehabilitation specialists, traumatologists), who work closely with other specialists to offer a comprehensive and personalised service to each patient, aimed at treating everything related to each patient’s pain.
If the cause of the pain cannot be treated or alleviated, or when the pain treatment has been insufficient, the specialists will assess other options, such as surgery.